We previously carried out an announced focused inspection at Stockton Heath Medical Centre 16 February 2017. The inspection was to check if the provider had carried out their plan to meet the legal requirements in relation to the breaches made during the announced comprehensive inspection on 24 February 2016.

The overall rating for the practice was good with a rating of requires improvement for the key question of responsive. The focused inspection report on the 16 February 2017 and the full comprehensive report on 24 February 2016 inspection can be found by selecting the ‘all reports’ link for Stockton Heath Medical Centre on our website at www.cqc.org.uk.

This announced, focused inspection was carried out on 26 July 2018 was to confirm that action had been taken to improve capacity for the provision of clinical appointments and to improve patient experience of access to the service as identified at our previous inspection on 16 February 2017. This report covers our findings in relation to these shortfalls found at our last inspection.

The practice is still rated as good overall and following this inspection rated as good for providing a responsive service.

Our key findings were as follows:

The practice had made improvements and addressed the issues identified in the previous inspection. Improvements included:

• Action had been taken to improve capacity for the provision of clinical appointments and improve patient experience of access to the service.
• The practice had recruited four new GPs and had used locum GPs to cover maternity leave.
• Extended access appointments with the nurse practitioner are available from 7.15am Tuesday, Wednesday and Thursday.
• Two new trainee assistant practitioners have been employed and the assistant practitioner has commenced training for GP assistant role.
• The practice employs an administration assistant who manage clinical correspondence to assist the GPs.
• There had been an increase of online appointments available and patients have been recommended to sign up for on-line access.
• The appointment system has been weighted to manage daily urgent care demand during morning sessions and pre-bookable appointments in the afternoon.
• Reception staff have received training in Care Navigation so they are now trained patient advisors.

At our previous inspection on 24 February 2017, we rated the practice as requires improvement for providing responsive services because although we found action had been taken to improve access to the service further improvement was needed.

At the 24 February 2017 inspection we found the practice should improve capacity for the provision of clinical appointments and improve the patient experience of access to the service.

At this focused inspection we found that improvements had been made to patient access and the number of available appointments had increased. The practice is now rated as good for providing responsive services.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

During this inspection we visited Stockton Heath Medical Centre, Warrington. We spoke with a GP / registered manager, practice manager, practice nurse, reception staff and a sample of patients on the day of our visit.

Patients spoken with were positive about the practice and commented that they were happy with the care they received. Comments received from patients included: “Excellent care and attention”; “Very efficient service” and “Constant high level of care.”

The practice provided patients' with a range of health care information leaflets and information on the practice and the complaints procedure was contained within the practice's leaflet, copies of which were in the waiting room.

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Stockton Heath Medical Centre on 24 February 2016. The full comprehensive report on the February 2016 inspection can be found by selecting the ‘all reports’ link for Stockton Heath Medical Centre on our website at www.cqc.org.uk.

At our previous inspection in February 2016 we rated the practice as ‘good’ overall but as ‘requires improvement’ for the key question of responsiveness. This was because improvements were needed to the appointments system to ensure it was responsive to the needs of patients. We issued a requirement notice as this was a breach of regulation.

This inspection visit was carried out on 16 March 2017 to check if the provider had carried out their plan to meet the legal requirements in relation to the breaches. This report covers our findings in relation to that and additional improvements made since our last inspection.

The findings of this inspection were that the provider had taken a number of actions to meet the requirement notice issued and improve patient experience of accessing the service. The provider had taken action to review and make changes to the appointments system. These changes had resulted in some improvement in patient experience of access and making an appointment. However, we found these areas required further improvement. The service therefore continues to be rated as ‘requires improvement’ for our key question of responsive.

Importantly, the provider should:

• Take action to improve capacity for the provision of clinical appointments and improve patient experience of access to the service.

The provider had also made a number of improvements to the service in response to recommendations we made at our last inspection;

• A review of staff roles and capacity had been carried out. As a result each day the GPs were allocated to responding to acute or routine patient concerns. Access had also been improved by using locum GPs. The practice had also secured two pharmacists to support the team. Clinical pharmacists work as part of the general practice team to resolve day-to-day medicines issues and consult with patients directly.

• Improvements had been made to the system for recording the actions taken in response to significant events and safety alerts. Significant events were being reviewed as part of a rolling rota for clinical meetings and a shared database was being used to provide staff with access to the records of clinical meetings.

• The arrangements for ensuring regular clinical audits were carried out had improved. The practice shared three clinical audits with us that had been commenced in the past 12 months.

• A system had been introduced to improve the arrangements for accounting for and storing blank prescriptions.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice